Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients

Hiroki Miura, Yoshiki Kawamura, Fumihiko Hattori, Makito Tanaka, Kazuko Kudo, Masaru Ihira, Hiroshi Yatsuya, Yoshiyuki Takahashi, Seiji Kojima, Tetsushi Yoshikawa

Research output: Contribution to journalArticle

Abstract

Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17%). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.

Original languageEnglish
Article numbere12916
JournalTransplant Infectious Disease
Volume20
Issue number4
DOIs
Publication statusPublished - 01-08-2018

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Human Herpesvirus 6
Herpesviridae Infections
Hematopoietic Stem Cells
Transplants
Odds Ratio
Confidence Intervals
Mortality
Transplantation
Logistic Models
Transplant Recipients
Unrelated Donors
Propensity Score
Virus Diseases
Hematologic Neoplasms
Real-Time Polymerase Chain Reaction
Regression Analysis
Tissue Donors
Viruses

All Science Journal Classification (ASJC) codes

  • Transplantation
  • Infectious Diseases

Cite this

Miura, Hiroki ; Kawamura, Yoshiki ; Hattori, Fumihiko ; Tanaka, Makito ; Kudo, Kazuko ; Ihira, Masaru ; Yatsuya, Hiroshi ; Takahashi, Yoshiyuki ; Kojima, Seiji ; Yoshikawa, Tetsushi. / Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients. In: Transplant Infectious Disease. 2018 ; Vol. 20, No. 4.
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abstract = "Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95{\%} confidence intervals (95{\%} CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5{\%}) of the HSCT recipients. Older age (OR: 10.3, 95{\%} CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95{\%} CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95{\%} CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95{\%} CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17{\%}). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95{\%} CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.",
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Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients. / Miura, Hiroki; Kawamura, Yoshiki; Hattori, Fumihiko; Tanaka, Makito; Kudo, Kazuko; Ihira, Masaru; Yatsuya, Hiroshi; Takahashi, Yoshiyuki; Kojima, Seiji; Yoshikawa, Tetsushi.

In: Transplant Infectious Disease, Vol. 20, No. 4, e12916, 01.08.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients

AU - Miura, Hiroki

AU - Kawamura, Yoshiki

AU - Hattori, Fumihiko

AU - Tanaka, Makito

AU - Kudo, Kazuko

AU - Ihira, Masaru

AU - Yatsuya, Hiroshi

AU - Takahashi, Yoshiyuki

AU - Kojima, Seiji

AU - Yoshikawa, Tetsushi

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17%). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.

AB - Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17%). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.

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